AccountId: 011433970860
ContactId: 2a3e237a-07b4-4fe0-ae43-b02197ecf331
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 179160 ms
Total Talk Time (AGENT): 97960 ms
Total Talk Time (CUSTOMER): 74489 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/2a3e237a-07b4-4fe0-ae43-b02197ecf331_20250403T12:06_UTC.wav
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[AGENT][NEUTRAL] Contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. This is [PII]. I'm calling from Doctor [PII]'s office, and I'm trying to, uh, confirm benefits for a member, please.
[AGENT][NEUTRAL] I can help with benefits, [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] 01826185 M as in Mary L as in Larry 8.
[AGENT][NEUTRAL] Thank you. And the patient's uh name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][POSITIVE] I do appreciate that. If I could have a callback number please the event that we're disconnected.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Well, first of all, [PII], the policy, this is a secondary gap insurance and it went into effect on [PII]. It is active. Um, now, the policy has both in and out of hospital benefits, um, treatment within a physician's office that's covered. Uh, there's also independent lab, um, coverage as well. So for outpatient services, um, anything that is, um,
[AGENT][NEUTRAL] And like the ER, urgent care, that sort of thing, outpatient surgery, we will pick up the deductible, co-payment or co-insurance up to $1500 for inpatient services, we'll pick up the deductible, co-payment or co-insurance from the major medical up to $4000 and this is just a verification the benefits, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, how about um services like a specialist office visit or minor diagnostics being done at the office?
[AGENT][NEUTRAL] Well, the, um, the treatment or procedures within the physician's office is covered um under the outpatient benefits of $1500. Again, just a verification, not a guarantee your payment, but the office visit co-pay, the office visit co-pay is not covered under this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Perfect. OK, and it's up to 1500, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, now, uh.
[CUSTOMER][NEUTRAL] Let me just confirm main address for claims because in the back of the card it says [PII], but the I have another address in my system that is a [PII]. Which one is it correct?
[AGENT][NEUTRAL] It's the [PII] address, um.
[AGENT][NEUTRAL] We, we were just changing it when they, when they got their policies. Yeah, so it's the [PII].
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect alright thank you very much for your help and did I get a reference number for the call?
[AGENT][NEUTRAL] Yes, this is um [PII], and the first letter of my last name is [PII]. We're gonna use that in today's date, [PII] is our uh reference.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you very much for your help you have a good day bye bye.
[AGENT][POSITIVE] OK, thank you for contacting you.